TY - JOUR
T1 - Menstrual Dysfunction in Girls from the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study
AU - Kelsey, Megan M.
AU - Braffett, Barbara H.
AU - Geffner, Mitchell E.
AU - Levitsky, Lynne L.
AU - Caprio, Sonia
AU - McKay, Siripoom V.
AU - Shah, Rachana
AU - Sprague, Jennifer E.
AU - Arslanian, Silva A.
N1 - Funding Information:
This work was completed with funding from the National Institute of Diabetes and Digestive and Kidney Disease/National Institutes of Health grants U01-DK61212, U01-DK61230, U01-DK61239, U01-DK61242, and U01- DK61254; from the National Center for Research Resources General Clinical Research Centers Program grants M01- RR00036 (Washington University School of Medicine), M01- RR00043-45(Children's HospitalLosAngeles), M01-RR00069 (University of Colorado Denver), M01-RR00084 (Children's Hospital of Pittsburgh), M01-RR01066 (Massachusetts General Hospital), M01-RR00125 (Yale University), and M01- RR14467 (University of Oklahoma Health Sciences Center); and from the National Center for Research Resources Clinical and Translational Science Awards grants UL1-RR024134 (Children's Hospital of Philadelphia), UL1-RR024139 (Yale University), UL1-RR024153(Children'sHospitalofPittsburgh), UL1-RR024989 (Case Western Reserve University), UL1- RR024992 (Washington University), UL1-RR025758 (Massachusetts General Hospital), and UL1-RR025780 (University of Colorado Denver).
Funding Information:
Financial Support: This work was completed with funding from the National Institute of Diabetes and Digestive and Kidney Disease/National Institutes of Health grants U01-DK61212, U01-DK61230, U01-DK61239, U01-DK61242, and U01-DK61254; from the National Center for Research Resources General Clinical Research Centers Program grants M01-RR00036 (Washington University School of Medicine), M01-RR00043-45 (Children’s Hospital Los Angeles), M01-RR00069 (University of Colorado Denver), M01-RR00084 (Children’s Hospital of Pittsburgh), M01-RR01066 (Massachusetts General Hospital), M01-RR00125 (Yale University), and M01-RR14467 (University of Oklahoma Health Sciences Center); and from the National Center for Research Resources Clinical and Translational Science Awards grants UL1-RR024134 (Children’s Hospital of Philadelphia), UL1-RR024139 (Yale University),UL1-RR024153(Children’sHospitalofPittsburgh), UL1-RR024989 (Case Western Reserve University), UL1-RR024992 (Washington University), UL1-RR025758 (Massachusetts General Hospital), and UL1-RR025780 (University of Colorado Denver).
Publisher Copyright:
© 2018 Endocrine Society.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Context Little is known about reproductive function in girls with youth-onset type 2 diabetes. Objectives To characterize girls with irregular menses and effects of glycemic treatments on menses and sex steroids in the Treatment Options for Type 2 Diabetes in Youth (TODAY) study. Design Differences in demographic, metabolic, and hormonal characteristics between regular- vs irregular-menses groups were tested; treatment group (metformin with or without rosiglitazone, metformin plus lifestyle) effect on menses and sex steroids over time in the study was assessed. This is a secondary analysis of TODAY data. Setting Multicenter study in an academic setting. Patients TODAY girls not receiving hormonal contraception and those at least 1-year postmenarche were included. Irregular menses was defined as three or fewer periods in the prior 6 months. Results Of eligible participants with serum measurement of sex steroids (n = 190; mean age, 14 years), 21% had irregular menses. Those with irregular vs regular menses had higher body mass index (BMI) (P = 0.001), aspartate aminotransferase (AST) (P = 0.001), free androgen index (P = 0.0003), and total testosterone (P = 0.01) and lower sex hormone-binding globulin (SHBG) (P = 0.004) and estradiol (P = 0.01). Differences remained after adjustment for BMI. There was no treatment group effect on menses or sex steroids at 12 or 24 months, and no association of sex steroids was seen with measures of insulin sensitivity or secretion. Conclusions Menstrual dysfunction is common in girls with recently diagnosed type 2 diabetes and associated with alterations in sex steroids, SHBG, and AST but not with alteration in insulin sensitivity or β-cell function and did not improve with 2 years of antihyperglycemic treatment.
AB - Context Little is known about reproductive function in girls with youth-onset type 2 diabetes. Objectives To characterize girls with irregular menses and effects of glycemic treatments on menses and sex steroids in the Treatment Options for Type 2 Diabetes in Youth (TODAY) study. Design Differences in demographic, metabolic, and hormonal characteristics between regular- vs irregular-menses groups were tested; treatment group (metformin with or without rosiglitazone, metformin plus lifestyle) effect on menses and sex steroids over time in the study was assessed. This is a secondary analysis of TODAY data. Setting Multicenter study in an academic setting. Patients TODAY girls not receiving hormonal contraception and those at least 1-year postmenarche were included. Irregular menses was defined as three or fewer periods in the prior 6 months. Results Of eligible participants with serum measurement of sex steroids (n = 190; mean age, 14 years), 21% had irregular menses. Those with irregular vs regular menses had higher body mass index (BMI) (P = 0.001), aspartate aminotransferase (AST) (P = 0.001), free androgen index (P = 0.0003), and total testosterone (P = 0.01) and lower sex hormone-binding globulin (SHBG) (P = 0.004) and estradiol (P = 0.01). Differences remained after adjustment for BMI. There was no treatment group effect on menses or sex steroids at 12 or 24 months, and no association of sex steroids was seen with measures of insulin sensitivity or secretion. Conclusions Menstrual dysfunction is common in girls with recently diagnosed type 2 diabetes and associated with alterations in sex steroids, SHBG, and AST but not with alteration in insulin sensitivity or β-cell function and did not improve with 2 years of antihyperglycemic treatment.
UR - http://www.scopus.com/inward/record.url?scp=85048652625&partnerID=8YFLogxK
U2 - 10.1210/jc.2018-00132
DO - 10.1210/jc.2018-00132
M3 - Article
C2 - 29697830
AN - SCOPUS:85048652625
SN - 0021-972X
VL - 103
SP - 2309
EP - 2318
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 6
ER -